Emerging therapies for diverticular disease of the colon.
Diverticular disease (DD) of the colon is common. This paper reviews the evidence supporting the role of some of the conventional medical therapies such as fiber and nonabsorbable antibiotics in the treatment of DD. More importantly, it will review the emerging body of evidence supporting the use of 5-aminosalicylic acid and probiotics for symptomatic or complicated DD. Possible mechanisms supporting the role of 5-aminosalicylates will also be discussed. On the basis of strength of the evidence supporting each medical intervention, recommendations will be graded in an evidence-based fashion. Finally, an evidence-based algorithmic approach is proposed for the medical management of DD. This paper does not discuss the use of absorbable antibiotics such as ciprofloxin and metronidazole, which are discussed in all standard textbooks. The purpose of this paper is to discuss newer recommendations.
Trivedi
Chirag D
CD
Division of Gastroenterology, Department of Medicine, Crohn's and Colitis Center of New Jersey, New Brunswick, NJ 08903, USA.
Das
Kiron M
KM
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004043:Dietary Fiber / Q000627:therapeutic use; D004239:Diverticulitis, Colonic / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D019804:Mesalamine / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004043:Dietary Fiber; D019804:Mesalamine